“The mind, which before massage is in a perturbed, restless, vacillating, and even despondent state, becomes calm, quiet, peaceful, and subdued after massage. In fact, the wearied and worried mind has been converted into a mind restful, placid, and refreshed.” — Thomas Stretch Dowse (1809-1885)
The benefits of massage are most apparent in cases in which muscular tension is so extreme that it becomes debilitating. Let us start with an especially vivid example from my own life. It involves a close friend who suffered psychotic episodes during which he became highly delusional. His breakdowns were so severe that he had to be hospitalized on three separate occasions. He had previously been diagnosed with schizophrenia as well as bipolar disorder, conditions that were precipitated by harmful life circumstances. His mother had recently died of cancer; his father had been murdered years before; he faced frequent bullying from hardened, streetwise men; he had gone through a harsh breakup, been homeless for months, and drank large amounts of caffeine every day.
In the days leading up to hospitalization, his thinking became severely deranged. He would become convinced that his friends were saints and that he was an angel responsible for preventing a coming apocalypse. Twice his state regressed to the point of catatonia, which has also been called “tension insanity.” Catatonia is a rare form of “psycho-motor immobility” in which a patient holds rigid poses, performs stereotyped, repetitive movements, and often cannot speak.1
On the first occasion, he was found by a mutual friend who called me to ask for help.When I arrived, I found our buddy standing rigidly, shaking, with a pained expression plastered on his face. He would not sit or lie down and had been standing for two straight days. He did not respond to speech or any form of communication. He squinted heavily. The circles under his eyes had become much darker than usual. He made no eye contact and stared vacantly at the floor. He was normally a conscientious person, but by the time I arrived, he was urinating and defecating in his shorts. When I checked his breathing, I found that each breath he took lasted about half a second and his tidal range was minimal.
Most worrying of all was his physical bearing. Although he was only 25, his posture was that of an old, sick man. He looked fragile, and the tension in his neck and back seemed excruciating. Having lost all concern for self-presentation, he looked as if he had been standing in a cold shower for hours. All his muscles were braced. I recognized his tortured posture as a direct expression of his pain-body, the suffering we all carry and attempt to conceal. At that point, I realized that if I were in a catatonic state, my postural deformities would similarly rise to the surface.
His catatonia made him very difficult to help. There was nothing we could do to move his rigid frame down the stairs and into the car. When we tried to carry him, he shook and moaned violently, and it became clear that he would need to relax if he were going to get to the hospital. So, I began massaging him. I started with his neck, then moved on to his shoulders and back. His back felt crooked, the curvature unnatural and deformed. But we rapidly made progress: at first, his spine resisted my efforts, but every minute he loosened up a little more, and within ten minutes, he was crying with relief. After 30, he was able to hobble to the car and sit down inside it.
On our way to the hospital, he uttered his only full sentence of the day: “If I calm down, I will die.” Experts consider catatonia to be a vastly reduced state of consciousness. Yet, from this state, he was able to verbalize perhaps the most entrenched albeit delusional conviction that all humans have. I did my best to explain to him why this was an irrational and self-defeating belief. I will spend the rest of this book attempting to convince you of the same. The main takeaway of this chapter is that massage can convince your body that relaxation does not come at the risk of death.
Getting to the hospital, though, was not the end of his struggles. For that visit alone, which turned out to be just the first of three, he owed more than $100,000 in medical bills. I asked him what the doctors did for him that cost so much, and he told me that they restrained him in a bed and gave him drugs for two weeks. (He wound up dependent on those drugs and had to be weaned off them slowly and painfully.) It is not clear what benefit the medicines and doctors provided, other than removing him from his stressful environment. Certainly, they conferred no long-term benefit.
I believe that a year of weekly, hour-long, deep-tissue, full-body massages would have largely rehabilitated him. At $50 per massage, this would have cost less than $3,000. If this had been his treatment, I think he would have had a much better chance at real, lasting recovery. If he had received $100,000 worth of massage therapy, this would have bought him 2,000 massages. That equates to an hour-long massage every week for 40 years. If I had been in charge of his health, I know how I would have invested the money.
After reading this chapter, you will know how to massage yourself for free. This will complement and reinforce the other Program Peace techniques you are using to promote your overall health.
Recent estimates indicate that around 98 percent of the atoms in the body are replaced every year. Despite this constant remodeling, the body unfortunately preserves its muscle tension. It does this because it treats tension as an essential form of memory. Our organism trusts and values the specific pattern of trauma distribution across our various limbs, organs, and body parts because that pattern is a historical record telling us exactly how best to be defensive. We were pre-programmed to conserve our tension, increase it as necessary, and die with it—but not to reverse it.
Modern medicine has no cure for muscular tension. There is no pill you can take to remove its physical manifestations. Compared to many other diseases and disorders, there is very little active biomedical research on curing muscular strain. Some researchers attempt to treat trigger points with injections, therapeutic ultrasound, or transcutaneous electrical stimulation, but none of these have yet proven very effective. I think basic and preclinical research on the issue should be given the highest priority in medicine, especially because persistent muscular tension is a contributing factor to many mental and physical diseases. Molecular pharmacologists will eventually develop a drug that completely eradicates muscular strain, but it will take decades for such a panacea to surface. Our bodies and minds don’t have decades.
That leaves us with non-clinical treatment options for the time being. Massage combined with diaphragmatic breathing is by far the best therapy available, and I recommend starting your practice immediately. I have been using physical compression for years to rouse dormant muscles all over my body. Before I began, I was covered in muscles that were painful to compress. Applying even light pressure almost anywhere stung. Now, all of these spots have become painless even when subjected to significant pressure.
Massage is effective for straightforward reasons. Compression forces the muscle to relax and allows it to reset to a lower level of tone. It feeds slack into the injured muscle, reversing muscle shortening and reducing mechanical deformation at the joint. It breaks down trigger points as well as deposits of calcium. It accelerates venous blood drainage and lymphatic clearance. Compression breaks up adhesions between muscle fibers and disintegrates scar tissue, freeing the fibers to slide past each other again. It is unclear exactly what compression does at the level of actin and myosin, the microscopic proteins discussed in the last chapter that form the structure of individual muscle fibers. Many researchers believe that it detaches strands of actin from myosin after they have become stuck together, allowing them to function freely again.
Specific conditions that are consistently and successfully treated with manual compressive therapy include headaches, back pain, neck pain, shoulder pain, carpal tunnel syndrome, shin splints, sciatica, TMJ, fasciitis, tendonitis, and many other soft tissue inflammatory disorders of the joints.2 Given the prevalence of those conditions and the general level of muscular tension that most of us develop over lifetimes of bracing and social submissiveness, self-applied trigger point massage is a necessary life skill.
One of the most studied therapies for combatting trigger points is a form of compression called soft tissue therapy, also referred to as “soft tissue mobilization” or “myofascial release.” The practice involves pinning down and squeezing an area of muscle with hard pressure for several seconds. The idea is to press firmly into soft tissue, including skin, fascia, periosteum, and superficially and deeply located muscles. The best locations for applying pressure are the trigger points themselves, which you can detect with your fingers. They often feel like a small length of partially cooked pasta or a slender worm under the skin. Most professional masseuses describe muscles with multiple trigger points as having a “crunchy” or “spongy” quality.
Muscles with trigger points are also easy to identify because they are tender to the touch. In contrast, healthy muscles don’t elicit a pain response under pressure. Tenderness should be your operative diagnostic criterion. Concentrate your efforts on any tender mass you find. Apply pressure, dig, and release. Use your knuckle, fingertip, the heel of your palm, or elbow to get in as deep as possible to break down the scar tissue and fibrous adhesions. The tip, side, or first knuckle of the thumb can be particularly useful. You want to compress tender muscles all over your body.
You can use a tool to avoid straining your hands or to apply pressure more easily to hard-to-reach areas. Pictured below are the implements that I use to perform compression on myself. You can find an eyebolt in any hardware store, and the other tools can be found easily online, if not at your local sporting goods store. Aside from my own hands, the Index Knobber, shown at the far right of the picture below, is my tool of choice.
Illustration 6.1: Tools for compression: A. Theracane TM / Backknobber TM, B. C. Baseballs attached with drilled holes and metal screws. D. Spiked massage ball E. Foam therapy ball F. Softballs, G. Tennis ball, H. Squash ball, I. Yoga therapy balls TM in sack, J. 3 sizes of eye bolts (1’’ x 8’’; .75’’ x 12’’; .5’’ x 6’’), K. Knobble TM, L. jacknobber TM, M. index knobber TM. You can also use tools like a hard water bottle, rolling pin, tennis ball, racquetball, barbell, or pipe.
The benefits of compression have to do with muscles’ need for microbreaks, which we have discussed previously. The muscles that feel tender when subjected to deep compression have not had the breaks they need to remain healthy. Compression gives them a much-needed respite, reestablishing blood flow and permitting full regeneration. The muscle may feel warm afterward as fresh blood rushes to areas that are normally neglected. To send fresh blood into an area, you first need to squeeze existing blood out by performing something called ischemic compression.
It is helpful to visualize the effects. As you massage, imagine that you are pressing into pale, pink tissue that has lost most of its blood supply. Envision the muscle turning white as you compress it and the remaining blood is squeezed out. Then, as you release, imagine fresh red blood flooding into the area. Imagine that this redness dissipates in a few seconds but that the muscle stays more brightly colored than it was before. Of course, all of that is quite literally happening. Compression creates the cellular events necessary to express the genes required to build new blood vessels. This renewed blood supply brings the muscle “back to life.” Below is an overview of the steps involved in the Program Peace compression routine.
- Use the tenets of diaphragmatic breathing throughout your massage practice. This will help ensure that your muscles remain relaxed even during discomfort. If compression becomes particularly painful, take a deep breath in, then breathe out slowly through pursed lips to extend your exhalation.
- Find a muscle that is tender when compressed. Press firmly on the muscle with the tip of a finger, knuckle, or tool for between five and 30 seconds. On most areas of the body, you can apply between five and 15 pounds of pressure. To gauge this, imagine a dumbbell of a given weight resting on top. Use less pressure on more painful or delicate areas. Release, reposition centimeters or millimeters away, and repeat.
- Some practitioners recommend sliding a finger, thumb, or tool down the length of the muscle. They use deep, firm strokes that move in the direction of the muscle fibers. Others recommend stroking across the muscle repeatedly, like strumming a guitar string. Try to develop skill at both. Either way, you want to pin the skin down and slide it over the muscle rather than slide your fingers over the skin. You can also simply press into an area of tenderness rather than stroke it. If I can find a taught, sore band of muscle, I will often nestle my knuckle in on one side of it and press rhythmically for minutes at a time.
- On a scale of one to ten, aim for a tolerable pain level of six or seven. Light massage at a pain level of two or three can also be beneficial but will take much longer to have an effect. At a six or a seven, the pain you feel should be mixed with pleasure. It should “hurt good” but should not be enough to make you squirm, brace, or breathe shallowly.
- Once you release the muscle, pay attention to how its level of bracing has diminished. You may feel insecure or exposed now that you are no longer bracing. Note the automatic tendency to either resume bracing or breathe shallowly. Resist both urges, continuing to breathe deeply while keeping the area relaxed. This will encourage the muscle to reset to a lower level of tone.
- Follow up. The next day, if the muscle is bruised or hurts when contracted, it is a sign that you pushed too hard. However, if it is slightly sore to the touch, then you made substantial progress. This soreness should disappear with just a few minutes of additional massage. After the soreness subsides, wait a few hours for it to come back and compress it again with the same degree of force. Repeat this process until the muscle no longer hurts to compress. Depending on the muscle’s size and the severity of the tension, this could take days, weeks, or months.
The steady, consistent pressure of compression therapy can be complemented by percussive massage. “Percussive” here means “hitting” or “striking.” Many professional masseuses routinely use slapping, beating, and pummeling, which are all examples of percussive massage. This approach is similar to the “tapotement” technique in Swedish massage and certain shiatsu regimens. It was documented to have been used in ancient Japan when children massaged their elders after long days bending over in the rice fields. Because the children’s fingers were not strong enough to perform a kneading motion, they balled up their hands and struck the sore muscles with their fists. The Japanese term “mago no te” was used to describe this type of massage, which translates to “grandchild’s hands.” The protocol below details a related method that I’ll refer to as “percussion.”
- Use a knuckle, fist, palm heel, baseball, or softball to repeatedly strike dormant, achy muscle. For even deeper muscle work, use a tool like the Index Knobber to strike.
- Use force and speed similar to what would be appropriate for conventional clapping/applause. Strike the muscle firmly and repetitively like a sewing machine or a woodpecker. Strike at a rate of roughly three to five times per second, rising one to three inches above the skin between strikes.
- Concentrate this pummeling action on a tender area of muscle just an inch or two in diameter for 10 to 45 seconds.
I percuss my neck, shoulders, back, arms, legs, knees, and ankles firmly all over with objects ranging from baseballs to knuckle-sized tools weekly. I recommend percussing your entire body with a hard implement. If you don’t have any of the tools below, don’t hesitate to start just using your knuckles or palm heel. Using percussion is one of the fastest and least painful ways to erode trigger points and reanimate dormant muscle
Illustration 6.2: Tools for percussion: A. Softball; B. Tennis ball; C. Eyebolt (.5’’ x 6’’); D. Jacknobber™; E. Index Knobber™; F. Bonger™; G. Brookstone vibrating massagers; H. Theragun™.
I strongly recommend that you spend around $100 on a handheld vibrating massager. Using it on your neck and head should give you the chills and make your body tingle, a clear sign that it is sorely needed. Use it wherever it feels good. Vibration tends not to work as well on trigger points as compression or percussion. However, even just one minute per day of vibratory stimulation will alleviate bracing and increase circulation. When used before bed, it can promote better sleep. Also, use it on tender muscles after massage. Doing so can encourage the well-worked muscles to relax further, which helps the massage do its work.
Aside from targeting small, localized areas of tissue with compression and percussion, it can be therapeutic to provide firm pressure to larger areas. This is a form of delocalized pressure that compresses, but also stretches, many muscles at the same time. This occurs when someone presses firmly into a large area of the body. Thai masseuses walk on the body to provide this kind of relief. Delocalized pressure pushes various muscle bracing pattern configurations outside their normally restricted range, which can have long-lasting positive effects. It will give your joints, including those in the spine, more play and articulation.
Several key pieces of advice are essential for practicing compression and percussion safely. Neither technique should ever damage tissue, nor should they bruise, scrape, or even irritate the skin. Avoid using compression on a recent injury, broken skin, or broken bones.
No matter the circumstances, medical professionals advise against compressing the following body parts: the eye, the inguinal ligament, the xiphoid process, the trachea, the median nerve near the carpal tunnel junction, the sciatic nerve, and the coccyx. Also, never massage a pulse. Many arteries accumulate plaque, and massaging them can dislodge that plaque and cause blood vessel occlusion. Additionally, avoid pressing or pinching lymph nodes.
Certain illnesses can also make massage a risky activity. If you have the following health conditions, consult your doctor before receiving or self-administering massage: aneurysm, atherosclerosis, cancer, congestive heart failure, coronary artery disease, peritonitis, or polycystic kidney disease. Other conditions that are usually contraindicated for massage include fever, cirrhosis, pitting edema, blood clots, deep vein thrombosis, embolism, fainting, uncontrolled high blood pressure, intestinal obstruction, lymphangitis, myocarditis, rheumatoid arthritis, tumors, seizures, and tuberculosis, among others.
Applied properly, the pressure of compression and percussion should involve only dull pain. On one hand, if the muscle doesn’t ache when you press into it, you are applying too little pressure and will not release the stored tension. On the other, the muscle should never hurt after you have stopped compressing. If it does, you have applied too much pressure or found an area that would best be avoided. Although compression feels like it causes pain, it would be more accurate to say that it reveals where pain already exists in your body. I believe that the level of discomfort you feel when compressing a tense muscle is proportionate to the subliminal pain signals that it sends your brain throughout the day.
It almost seems unfair that to rid ourselves of pain, we must endure it even more intensely. But there is an optimistic perspective on soft tissue release. The muscular strain that you endure today is the product of years or even decades of tension. And yet, many muscles can be largely rehabilitated in just a handful of five-minute sessions. After that initial period of regular massage, less than one minute per month can be sufficient to maintain these results. This suggests that every minute of soft tissue release reverses weeks or even months of strain. Additionally, keep in mind that if you choose not to release your muscles, you are allowing them to become tenser, raising your levels of stress and anxiety and perpetuating chronic pain and autonomic imbalance.
It is vital to appraise soft tissue therapy positively. It is “invasive” in some ways, but you want your body to embrace the sensations that you feel rather than reject them. The key is to self-soothe and trigger your natural relaxation response. To that end, it is imperative to use diaphragmatic breathing. Many specialists agree that deep breathing helps the muscle spindles receive the message to stop contracting.
There is a wealth of massage instructions and tutorials on the internet. Simply Google “how to massage.” Or, if video instruction appeals to you, YouTube it. I also recommend using other guides on muscle release such as Jill Miller’s The Role Model and Clair Davies’ The Trigger Point Therapy Workbook. As a baseline, the exercises that follow highlight a few of the areas that I think are essential to compress and percuss.
Illustration 6.3: Hand massage.
Illustration 6.4: Foot Massage.
Illustration 6.5: Temporalis massage.
Illustration 6.6: Sternocleidomastoid massage.
Illustration 6.7: Occipitalis massage.
Illustration 6.8: Neck massage.
Illustration 6.9: Corrugator supercilii massage.
The results of even these simple exercises can be profound. Let’s look at the corrugator supercilii muscle in Exercise 6.7, for example. It is the muscle that creates the frown, which it does by lowering the eyebrows and pulling them together. Scientists regard it as the principal muscle in the expression of suffering.3 This means that humans, primates, and other mammals unconsciously contract their corrugator supercilii muscles when experiencing great pain. What do you think it means for this muscle itself to be stuck in painful, partial contraction? I think it means that it has come to perpetuate the condition of suffering. Realizing this strongly motivated me to compress mine until they were absolutely painless. In total, the process took me about an hour, divided into several short sessions spread over a month. It was time well spent as it released my perennial frown and changed my outlook on the world.
Below are several other easy-to-use massage techniques that should help kickstart your search for soreness and a personal routine. Other chapters in this book will specifically address massage of the face (9), neck (16), and lower back (17).
Illustration 6.10: Easy-to-use massage techniques.
The health benefits of self-massage are both real and noticeable: compression increases circulation, improves joint health, relieves muscular injuries, shortens recovery time, and reduces muscle fatigue. Aesthetically, self-massage can accentuate muscle mass, reduce the deposition of fat, improve the appearance of cellulite, and contour, tone, and firm the skin. I have released muscles all over, and it has helped me feel as though I have an entirely new body. I am stronger, more flexible, faster, and more graceful. Results are cumulative. It should be everyone’s objective to release every painful muscle in the body. Finding them and learning how to compress them skillfully is a challenge, of course, and one of the best ways to start learning is to receive professional massage.
Getting expert help can be the perfect introduction or complement to a self-treatment routine. If the option is available, I strongly recommend that you invest a significant proportion of your disposable income for the next few years on deep tissue massage. Receiving quality deep tissue massages will relieve pent-up tension in large portions of your body, curbing sympathetic hyperactivity and activating pain-gate control. It has even been shown to reduce depression and trait anxiety4 and reduce generalized anxiety disorder symptoms.5 What is more, it temporarily reduces blood pressure and heart rate and stimulates the production of the brain chemicals involved in pleasure and satisfaction, such as endorphins, oxytocin, and serotonin.6 Raising the levels of these substances in your brain has recursive beneficial effects on happiness, confidence, and outgoingness.
I had my first massage at age 27. I came out of the studio angry, convinced that the masseuse had pressed too firmly on my shoulder. By the time I got to my car, I had a bad cramp in my deltoid that stayed with me for a full week. The cramp formed for three reasons: (1) I didn’t ask the masseuse to reduce the excessive pressure, (2) I was a full-on thoracic breather at the time, and (3) I defensively contracted the muscle into a tight ball as it was being massaged. Massaging a muscle too intensely, especially when it is contracted, will make the muscle worse rather than better. It is important to remember that unlike in self-massage, the professional masseuse cannot feel what you experience as they press. They need your active feedback telling them when to press harder and when to press softer.
This bad first experience, which was my fault, dissuaded me from returning. Reading about the scientific benefits of massage five years later persuaded me to give massage another chance. By this time, I was practicing diaphragmatic breathing, which helped me accept, rather than brace against, the most intense parts of the massage. This second experience made me a convert.
At first, the masseuses I saw marveled at how tight my muscles were. Several voiced concern for my well-being after feeling my neck and shoulders. They would say things like: “This isn’t good, are you okay?” I was even told by several masseuses that I had the worst muscle tension they had ever seen. But that feedback started to change within the first year of weekly deep tissue massages. By the end of the year, each new masseuse I worked with commented that they had never seen anyone able to take such deep pressure. It just didn’t hurt anymore, and it hasn’t since. I attribute this entirely to the consistent practice of diaphragmatic breathing.
Deep tissue massage should be uncomfortable at times but should not cause excessive pain or induce protective spasms. When a masseuse presses too hard on a trigger point, other trigger points throughout the body will briefly flare up in response. Encourage them to press hard but never to the point where the pain causes you to tense up in other areas, such as your face, neck, or back. To this end, concentrate on holding a relaxed “corpse pose,” allowing your body to go completely limp.
Most importantly, you will know that the massage is too hard if it makes you breathe shallowly or brace your diaphragm. As mentioned above, you should be practicing diaphragmatic breathing throughout the massage. Employing paced breathing is ideal. To do this, locate the breath metronome MP3 audio tracks available from my website, upload them to your phone, and play them during the massage (you may want to put the track on repeat to keep your hands free and turn off the screen of your phone to conserve battery life). Diaphragmatic breathing will keep your muscles from fighting against the forced relaxation. This has the added benefit of reducing the extent of soreness afterward.7
Illustration 6.11: A. Massage of the temporal muscles; B. Skeletal muscles of the back; C. Neck massage.
Most masseuses, whether they realize it or not, specialize in treating the muscles of respiration. This is because any muscle of the torso can be seen as a muscle of respiration. After all, every one of them either mobilizes or stabilizes breathing motions. Remember how we said that breathing with the muscles surrounding the thorax and clavicles is especially unhealthy? Any decent massage of the neck, shoulders, or back will release those muscles, helping diminish the strain responsible for thoracic and clavicular breathing. Also, you will find that during a relaxing massage, your breathing becomes diaphragmatic on its own and that the activity of your sympathetic stress system plunges. Stress and anxiety cannot remain chronic if you give yourself intermittent, restorative breaks in the form of professional massages.
Receiving regular professional massages will teach you how a good massage manipulates muscle, making it easier to give yourself or others effective massage later on. You will also quickly learn where on your body the muscles are dormant so that you can compress them yourself. Additionally, massage conditions dominant traits such as not flinching or pulling away when touched, relaxing completely around others, and being comfortable while in close physical contact with people you don’t know well. These traits will add to your overall sense of ease and confidence in the world around you.
Due to reductions in chronic tension and an increased blood supply, after a high-quality deep tissue massage, you will find yourself able to jump higher, run faster, and bench press more. You will have more energy, better endurance, and exercising will be more pleasurable. To help capitalize on those improvements, I strongly recommend exercising before a deep tissue massage. Afterward, you want to stretch and exercise the muscles that have been released, but you don’t want to overload them. You do not want to go to a batting cage, lift heavy weights, spar, or load up a moving truck. Do these things before a deep tissue massage, but not after.
Most importantly, massage will allow you to flex into and exercise within positions that were previously barricaded. You will find that you can contract portions of muscles that were once completely unavailable. They become available because the massage gives them a temporary blood supply, allowing them to flex like healthy, active muscle tissue is supposed to. Subsequent chapters (13-18) will detail how to combine massage with exercise to reopen musculoskeletal obstructions.
I recommend trying as many different masseuses as possible. Almost any massage is going to be of value, but only a certain percentage of masseuses are worth your time and money. Your goal is to find the masseuses in your vicinity who are best at searching out and pressing into the aching, tense parts of your body. This does not necessarily mean paying top dollar. The most helpful massages I have received myself were not the most expensive ones. The Chinese acupressure studio in the mall near my home is consistently the best. In my experience, traditional Chinese massage has excellent biological validity. They know where trigger points are and how to compress them firmly while slightly varying the location of pressure every few seconds. I also stand by Thai massage, medical massage, sports massage, active release technique, osteopathic manipulation, myofascial release therapy, and trigger point therapy. With a skilled practitioner, each of those schools can lead to extremely positive outcomes.
Having reviewed the most important ways in which touch can heal, let’s return to the story that opened the chapter. That was not the only time I found my friend in crisis. Nor was it the worst.
The third time I had to take my friend to the hospital was the most dramatic. Homeless again, he had spent a few weeks with some mutual friends. One of them was another transient who harried and browbeat him constantly. After less than a week of this abuse, his speech was accelerated and the things he said came primarily from resentment and frustration. One day, I was looking after him along with a woman he was dating. We watched his mental state slowly devolve over just a few hours, and by nighttime, his behavior was delirious. He was pacing and ranting in a state of purposeless volatility. In the episode I described at the beginning of this chapter, my friend was in a state of catatonic stupor. This time, his condition was catatonic excitement, commonly cited as one of the most dangerous mental states in psychiatry.
Patients in a state of catatonic excitement are completely impulsive and exhibit bizarre, non-goal-directed hyperactivity. My friend was storming around restlessly, pointing, yelling, and making wild accusations, raving about a new topic every two sentences. It took me 20 minutes of this to realize that even though he was on his feet and talking, he was barely conscious. His nonsensical, incoherent ranting seemed inexhaustible. He wouldn’t let anyone touch him and started yelling when any of us came near him or made eye contact. He repeatedly jabbed his finger into the chest of a common friend while screaming. As soon as he made a violent physical overture toward his girlfriend, I quickly but gently used a wrestling takedown to bring him to the floor. I knew that using physical force with a person with a mental health condition is unethical, but I reacted to protect the others. I spoke to him in a friendly, authoritative way and massaged him firmly. I kneaded the muscles along his spine for a half-hour until he started weeping in relief. Remarkably, our friends were able to talk him into going back to the place he dreaded the most. I can’t imagine that any intervention other than massage could have helped him relax enough to make that choice willingly.
It was his third admission to a psychiatric hospital in two years. After four days there, he was expelled for fighting with other patients. I spent hours searching streets near the institution before I found him shivering in the rain. He was frenzied, rambling madly, with a swollen lip and a gash over his eye. All his medications had been stolen from him and he was “crashing down” as the prescribed drugs cleared from his cerebral circulation. Withdrawal from the sedatives and antipsychotics caused his sympathetic stress system to go berserk. I realized that no matter what we did, he would seek out and engage the most upsetting aspect of any scenario I put us in.
So, we avoided stimulation. I checked us into a hotel in a quiet neighborhood and spent three days with him, working hard to remain as calm and as boring as possible. To avoid overstimulating him, I hid my phone and took the room’s television down to the front desk. At that time, he could only fathom what was physically in front of him, so because there was no television in the room, he didn’t miss it. Instead, I brought a few board games for us to play. I spent most of the time trying to be the perfect combination of nondominant and nonsubmissive. He tried to dominate me, he tried to act submissive toward me, and I ignored these so as not to reinforce either.
During that time, I also practiced many breathing exercises with him. He said he liked them, but he was so restless that he could only concentrate on them for a few seconds at a time. He did not have the attention span necessary for paced breathing. For this reason, every half hour I asked him to take one long, slow inhalation and one complete exhalation while blowing on his finger. He said it made him sleepy. Calming our anxiety with proper breathing can make us drowsy, but only at first. Many people assume that becoming sleepy is an unavoidable part of relaxation. It is not. Performing the diaphragmatic breathing exercises in Chapter 3 over several weeks will prove to you that relaxation sharpens attention in the long run. The next chapter will discuss the biology of how becoming calmer, paradoxically, makes you more alert. After coaching him to take many steady, full breaths in a row, I took him to get a massage.
We went to an 80-pound woman who gave hour-long, full-body massages for $20 at a storefront on Hollywood boulevard. She had to be more gentle than usual because he could barely stand even mild pressure. I glanced at him and saw him shuddering, convulsing in what I took as the ecstasy of the woman’s touch meeting the agony of his pain-body. He started moaning, and when she asked whether she should continue, his reply was, “Please.” A few minutes later, he started sobbing and didn’t stop for the remaining 45 minutes. The other people at the parlor didn’t even complain about all the noise he was making because they could tell what he was going through.
A couple of hours after his massage, he looked bright, fresh, and reinvigorated. His appearance contrasted starkly with his appearance described at the beginning of this chapter. It was abundantly clear that various chakra-like modules were finally given the break they needed to begin restoration and regeneration. This included muscles that were never even touched by the masseuse. His face, voice, heart, diaphragm, and gut had the brief respite they needed to recharge. All because his inner animal was given 60 minutes to forget about its interminable fear of death.
Having never had a massage, he said it was the best experience of his life and asked when we could go again. Of course, his case is an extreme example. Most of us don’t carry this amount of trauma or have such deeply rooted pain bodies. But massage, be it professional or self-administered, is among our most effective and accessible means of treating both.
Personal grooming (or preening) is widespread in animals and is a hygienic behavior aimed at extracting foreign objects from the body’s surface. It is done to remove insects, ectoparasites, leaves, dirt, and twigs. Social grooming is common in mammals and involves stroking, scratching, massaging, licking, and gentle biting of another animal. Even animals such as birds, horses, bats, lions, and insects groom each other. Apes and monkeys groom one another daily, and the consequent trust and bonding are critical to group cohesion. Grooming plays a role in establishing alliances, is imperative for reconciliation after conflict,8and is one of the main ways that primates reduce stress and tension.9
In humans and other mammals, gentle, well-meaning touch stimulates the release of beta-endorphin. This natural analgesic attaches to the same brain receptors as morphine, heroin, and other drugs derived from the opium poppy.10Synthetic opioid street drugs increase the traumatic load on our bodies by leading to extreme withdrawal. But increasing the levels of natural endorphins produced by your brain does not and may be among the healthiest things you can do. It increases overall well-being. Grooming, massaging, rubbing, cuddling, and caressing all have this effect. This is partially responsible for the fact that primates with the most grooming relationships tend to be healthier on average.
Do dominant primates groom a lot or a little? What would be your guess? In fact, they groom others the most. Because the dominant primates usually have the highest circulating endorphin levels, they typically do not need to be groomed to relax but are the most willing to groom others. Most humans do not regularly rub or massage others. Do you? I think that many people are apprehensive about being affectionate because they are concerned that their manual skills are not good enough, or they worry about the social aspects of the interaction. More than anything, they don’t want to have their efforts rejected. But much of this is a question of familiarity and repetition—you can’t get good if you don’t try. A little bit of time and practice will allow you to pass that apprehensive barrier and feel at ease touching and rubbing other people. As with other skills we’ve discussed, you can develop the ability on your own before perfecting it with others.
When you find the opportunity, practice stroking and caressing another person in a smooth, rhythmic, and doting way. Alternate between using your whole hand and the tips of your fingers. Don’t hesitate or pause and try to keep your fingers from skipping along their skin. Rather, maintain fluid contact. Lightly squeeze their skin between your fingers and tug at it gently. You can rub their entire body, alternating between pressing and caressing. This kind of positive physical touch can work wonders for your spouse, children, or pets.
Caress, like vibration, does not release hypertonic muscles in the same way that compression or percussion does. It undoes tension through relaxation by significantly reducing conscious bracing. However, if the person being massaged feels uncomfortable, they may actually brace more, like a pet that doesn’t want to be picked up. Many people cringe and reject touch due to past physical trauma. As the one doing the touching, it is your responsibility to touch them in a way that causes their bracing to subside. Affectionate, attentive, and flowing movements will do this.
Try rubbing or caressing your significant other as you listen to music. It can help coordinate and sensualize your movements. Rubbing and massaging the scalp is one of the best ways to release endorphins. One way to approach this is to start by pressing the tip of your thumb firmly into their upper neck and then the occipital muscles on the back of their head. Sensually depress, release, and reposition once every two seconds. Use your thumb to stroke firmly over the hair shafts around the nape of the neck, making a crackling sound, and stimulating the copious nerve endings in the area. Massaging the entire scalp in this way, rubbing it rhythmically with all ten finger pads, can be intensely pleasurable. Try lying next to your partner, nestling against them, and fondling their arms, back, and shoulders. You might lie on your back and have a significant other lie on top of you, stomach to stomach, so that you can rub their neck, back, bottom, and legs with both hands.
It is known that in primates, the grooming animal enjoys levels of pleasure chemicals that are comparable to the individual being groomed. It is the same in humans. Stroking your cat or dog releases endorphins, reduces heart rate, and drops blood pressure in the pet as well as in the human doing the petting.11 Without question, massaging and caressing someone else is the most pleasurable, stress-reducing, and bonding activity I know of. I believe that many people feel unsated because they mistakenly seek this form of satisfaction from kissing and sex, which simply don’t provide it. One look at the pervasiveness of grooming in primates convinces me that our bodies are biologically prepared for, and expectant of, being rubbed and caressed. We are doing ourselves a disservice by not doing it regularly.
Illustration 6.12: Massage techniques.
Psychologists have long been puzzled by the fact that people who experience windfalls, such as winning the lottery, do not stay happy for long. Humans tend to return to a stable set point for subjective well-being and life satisfaction within a short period following major positive or negative life events. This phenomenon has been called the “hedonic treadmill.”12 You can increase the speed as much as you want on a treadmill, but you won’t get anywhere. In life, you can accumulate as many riches and accolades as you want, but it likely won’t make you any happier or more peaceful. A good deal of psychological research has been devoted to grappling with this issue because it seems inherently unsettling. If fulfilling our lifelong dreams and ambitions does not reduce our pain, what will?
Well, massage will. Trigger points keep us tethered to the hedonic treadmill. Winning the lottery does nothing to remove years of built-up tension in our bodies. However, breathing retraining, compression, percussion, and caressing do precisely that. They alleviate pressure and pain. They give us long-term, renewable increases in the levels of pleasure-causing chemicals in our brains. They bring us closer to other people and help us learn to be more comfortable with them physically.
You probably know someone in their nineties who has terrible posture. They would be spry and dexterous if only they had enjoyed a monthly deep tissue massage throughout their life. Many people assume that frailty, muscle pain, and loss of muscle mass are simply inevitable concomitants of aging. They are not. They are merely the cumulative toll of continuous tension.
To help reverse the effects of long-term muscle strain, I recommend creating a monthly budget for deep tissue massage. For the first several months, spend as much of your discretionary income on it as possible. Then, transition into doing it yourself. Recruit your friends, family members, and partners to practice massage with you. Whether you do it yourself or practice mutual massage with a loved one, it is a free way to rapidly increase your wellbeing.
- Massage can repair tense, painful muscles all over the body. It works by forcing partially contracted muscles into a resting state, which allows them to regenerate, heal, and receive fresh blood and nutrients.
- Pressing firmly into tender, achy muscle provides ischemic compression, which forces the blood out of the tissue and then, when released, increases blood flow.
- Muscles that are sore when compressed are the most in need of massage.
- All the muscle soreness in your body can and should be removed by massage.
- Performed regularly, compression will restore proper length and tone to the muscle, increasing its range of motion, strength, and regenerative capacity as well as reducing tension and pain.
- There are key areas of the body that, when massaged, can recover providing tremendous benefits.
- Muscle compression is most effective when used with diaphragmatic breathing.
- Percussion is another massage modality that involves gently but rapidly striking a muscle. Vibration is a third modality that uses a vibrating, electric massage tool.
- Massage also improves posture, athleticism, muscular endurance, coordination, flexibility, and mobility.
- Learning to massage yourself is awkward at first. Achieving the ability to do it effectively may take months but is a skill worth investing time in. Getting professional massages can help the learning process.
- Grooming in primates is vital to stress reduction, social cohesion, and well-being. You can achieve the same positive outcomes by making time to affectionately massage, rub, and caress those closest to you.
- Burrow, J. P., Spurling, B. C., & Marwaha, R. (2020). Catatonia. In StatPearls. StatPearls Publishing.
- Braun, M. B., & Simonson, S. J. (2008). Introduction to massage therapy. Lippincott Williams & Wilkins.
- IFridlund, A. J. (1994). Human facial expression: An evolutionary view. Academic Press.
- Moyer, C. A., Rounds, J., & Hannum, J. W. (2004). A Meta-analysis of massage therapy research. Psychological Bulletin, 130(1), 3–18.
- Rapaport, M. H., Schettler, P., Larson, E. R., Edwards, S. A., Dunlop, B. W., Rakofsky, J. J., & Kinkead, B. (2016). Acute Swedish massage monotherapy successfully remediates symptoms of generalized anxiety disorder: A proof-of-concept, randomized controlled study. The Journal of Clinical Psychiatry, 77(7), e883–91.
- Fritz, S. (2016). Mosby’s fundamentals of therapeutic massage. Elsevier Health Sciences.
- Weerapong, P., Hume, P. A., & Kolt, G. S. (2005). The mechanisms of massage and effects on performance, muscle recovery and injury prevention. Sports Medicine, 35(3), 235–256.
- Smuts, B., Cheney, D., Seyfarth, R., Wrangham, R., & Struhsaker, T. (1987). Primate societies. University of Chicago Press.
- Schino, G., Scucchi, S., Maestripieri, D., & Turillazzi, P.G. (1988). Allogrooming as a tension-reduction mechanism: A behavioral approach. American Journal of Primatology, 16(1), 43–50.
- Keverne, E. B., Martensz, N. D., & Tuite, B. (1989). Beta-endorphin concentrations in cerebrospinal fluid of monkeys are influenced by grooming relationships, Psychoneuroendocrinology, 14(1–2), 155–161.
- McConnell, P. (2003). The other end of the leash: Why we do what we do around dogs. Ballantine Books.
- Frederick, S., & Loewenstein, G. K. (1999). Hedonic adaptation. In D. Kahneman, E. Diener, & N. Schwarz (Eds.), Well-being: The foundations of hedonic psychology (pp. 302–329). New Russell Sage Foundation.